Correlation Between Thyroid Papillary Carcinoma And Cervical Lymph Node Metastases Based On Ultrasonic Radiofrequency Signal

Objective Papillary thyroid carcinoma(PTC)is the most common pathological type of thyroid carcinoma,and is prone to cervical lymph node metastases(CLNM).We aim to evaluate the correlation between ultrasonic radio frequency(RF)signal of PTC and CLNM.Methods 170 patients with PTC confirmed by pathology after thyroidectomy from July 2019 to May 2022 were enrolled in this retrospective cohort study.All patients were divided into positive and negative group according to CLNM.Univariate analysis was performed to predict CLNM and receiver operating characteristic(ROC)curve was created to evaluate diagnostic performance for RF signal and TI-RADS.Linear regression analysis was performed for the parameters with AUC>0.50 to obtain the indicators that were significantly related to CLNM.Results Among 170 patients,182 nodules were included in the study,of which 11 were multiple nodules.Based on the patients,68 cases(40.0%)were positive group with CLNM,and 102 cases(60.0%)were negative group without CLNM.Based on the nodules,74 cases(40.7%)were positive group with CLNM,and 108 cases(59.3%)were negative group without CLNM.Univariate analysis showed that age,maximum tumor diameter,cross-sectional and longitudinal aspect ratio,RF quantitative parameters(cross-sectional Intercept,Mid-band,S1,S4,longitudinal Higuchi,Slope,Intercept,Mid-band,S1)and echogenic foci were independently associated with CLNM metastatic status(P<0.05).The area under the curve(AUC)of maximum tumor diameter was 0.68,the specificity was 73.1%,and the sensitivity was 60.8%.The AUC of longitudinal Slope was 0.61,the specificity was 67.6%,and the sensitivity was 55.4%.The AUC of echogenic foci was 0.62,the specificity was 62.0%,and the sensitivity was 58.1%.Linear regression analysis of maximum tumor diameter,longitudinal Slope and echogenic foci were performed,the correlation between maximum tumor diameter and CLNM was the largest(β=0.285).The correlation between longitudinal Slope and CLNM was greater than that of echogenic foci(β=0.203 vs.β=0.154).Conclusion Maximum tumor diameter of the nodule has the greatest correlation with CLNM of PTC.Larger tumors are the high-risk factors of CLNM.The longitudinal Slope and echogenic foci have similar diagnostic efficacy in predicting the risk of CLNM in PTC,but longitudinal Slope has greater correlation with CLNM.